{"id":278408,"date":"2021-06-18T17:48:43","date_gmt":"2021-06-18T17:48:43","guid":{"rendered":"https:\/\/www.bhump.org.uk\/?page_id=278408"},"modified":"2021-06-18T17:56:55","modified_gmt":"2021-06-18T17:56:55","slug":"volunteer-application-form","status":"publish","type":"page","link":"https:\/\/www.bhump.org.uk\/km\/volunteer-application-form\/","title":{"rendered":"\u1791\u1798\u17d2\u179a\u1784\u17cb\u1796\u17b6\u1780\u17d2\u1799\u179f\u17bb\u17c6\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"278408\" class=\"elementor elementor-278408\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"has_ae_slider elementor-section elementor-top-section elementor-element elementor-element-7a8ac910 elementor-section-boxed elementor-section-height-default 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value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_validate_outside_101\" data-id=\"arf_is_validate_outside_101\" data-validate=\"0\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_resetform_aftersubmit_101\" data-id=\"arf_is_resetform_aftersubmit_101\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_resetform_outside_101\" data-id=\"arf_is_resetform_outside_101\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_form_enable_cookie_101\" data-id=\"arf_form_enable_cookie_101\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_tooltip_settings_101\" data-id=\"arf_tooltip_settings_101\" class=\"arf_front_tooltip_settings\" data-form-id=\"101\" data-color=\"#FFFFFF\" data-position=\"top\" data-width=\"\" data-bg-color=\"#000000\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_tooltip_error_101\" data-id=\"form_tooltip_error_101\" data-color=\"\" data-position=\"bottom\" value=\"advance\" \/><input type=\"text\" data-jqvalidate=\"false\" name=\"fake_text\" data-id=\"fake_text\" value=\"\" style=\"height:0 !important; margin:0 !important; opacity: 0 !important; filter:alpha(opacity=0); padding:0 !important; width:0 !important; float:left;\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfaction\" value=\"create\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_id\" data-id=\"form_id\" value=\"101\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_data_id\" data-id=\"form_data_id\" value=\"73261\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_key\" data-id=\"form_key\" value=\"m3fbu4\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"is_load_js_and_css_in_all_pages\" data-id=\"is_load_js_and_css_in_all_pages\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_display_type\" data-id=\"form_display_type\" value=\"0|https:\/\/www.bhump.org.uk\/km\/volunteer-application-form\/\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_submit_type\" data-id=\"form_submit_type\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_http_referrer_url\" data-id=\"arf_http_referrer_url\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"entry_key\" value=\"\" \/><div class=\"allfields\"  style=\"visibility:hidden;height:0;\"><div class=\"arf_fieldset arf_standard_form\" id=\"arf_fieldset_73261\"><div id=\"arf_wizard_table\" class=\"arf_wizard top\"><div class=\"arf_wizard_upper_tab\"><div style=\"width:50.000%;\" id=\"page_nav_1\" class=\"page_break_nav page_nav_selected\">\u1787\u17c6\u17a0\u17b6\u1793\u1791\u17b8 1<\/div><div style=\"width:50.000%; \" id=\"page_nav_2\" class=\"page_break_nav\">\u1787\u17c6\u17a0\u17b6\u1793\u1791\u17b8 2<\/div><\/div><div class=\"arf_wizard_lower_tab\"><div style=\"width:50.000%; padding:0;\" id=\"page_nav_arrow_1\" class=\"page_break_nav page_nav_selected\"><div class=\"arf_current_tab_arrow\"><\/div><\/div><div style=\"width:50.000%;padding:0;\" id=\"page_nav_arrow_2\" class=\"page_break_nav\"><\/div><\/div><\/div><div class='arf_wizard_clear' style='clear:both; height:15px;'><\/div><div id=\"page_0\" class=\"page_break\"><input type=\"hidden\" id=\"arf_repeatable_field_counter_180\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_180\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' ><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_181_73261_container\" class=\"arfformfield input-field control-group arfmainformfield  arffieldrequired arf_field_type_select  top_container  top_container arfformfield  arf_field_181\"  style='width: 100%'  data-field-type=\"select\" data-parent_field=\"180\"><label data-type=\"select\" for=\"field_5c9nh0_73261\" class=\"arf_main_label arf_main_label_18px active\">\u1798\u17bb\u1781\u178f\u17c6\u178e\u17c2\u1784\u178a\u17c2\u179b\u1780\u17c6\u1796\u17bb\u1784\u178a\u17b6\u1780\u17cb\u1796\u17b6\u1780\u17d2\u1799<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"sltstandard_front controls\"  ><select name=\"item_meta[181]\" data-validation-required-message=\"This field cannot be blank.\" id=\"field_5c9nh0_73261\"  class=\"select_controll_181 arf_required arf_select_controll\"style=\"width:auto;min-width:100px; \" data-size=\"15\" data-default-val=\"\"   ><option value=\"\" selected=\"selected\"  data-content=\"Please select\">Please select<\/option><option value=\"Volunteer ESOL Tutor \"  data-content=\"Volunteer ESOL Tutor \">\u17a2\u17d2\u1793\u1780\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f ESOL Tutor <\/option><option value=\"Volunteer Maths Tutor\"  data-content=\"Volunteer Maths Tutor\">\u1782\u17d2\u179a\u17bc\u1794\u1784\u17d2\u179a\u17c0\u1793\u1782\u178e\u17b7\u178f\u179c\u17b7\u1791\u17d2\u1799\u17b6\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f<\/option><option value=\"Volunteer Web Designer\"  data-content=\"Volunteer Web Designer\">\u17a2\u17d2\u1793\u1780\u179a\u1785\u1793\u17b6\u1782\u17c1\u17a0\u1791\u17c6\u1796\u17d0\u179a\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f<\/option><option value=\"BHUMP Volunteer\"  data-content=\"BHUMP Volunteer\">\u17a2\u17d2\u1793\u1780\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f BHUMP<\/option><\/select><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_124\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_124\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' 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data-size=\"15\" data-default-val=\"\"   ><option value=\"\" selected=\"selected\"  data-content=\"Please select\">Please select<\/option><option value=\"Mr\"  data-content=\"Mr\">\u179b\u17c4\u1780<\/option><option value=\"Mrs\"  data-content=\"Mrs\">\u17a2\u17d2\u1793\u1780\u179f\u17d2\u179a\u17b8<\/option><option value=\"Ms\"  data-content=\"Ms\">\u17a2\u17d2\u1793\u1780\u179f\u17d2\u179a\u17b8<\/option><option value=\"Miss\"  data-content=\"Miss\">\u1780\u1789\u17d2\u1789\u17b6<\/option><\/select><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_126_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield frm_third  arf_inline_field_value  arf_field_126\"  style='width: 37.542%' data-field-type=\"text\" data-parent_field=\"124\" ><label data-type=\"text\" for=\"field_pnv2s8_73261\" class=\"arf_main_label arf_main_label_18px\">\u1793\u17b6\u1798\u178f\u17d2\u179a\u1780\u17bc\u179b<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_pnv2s8_73261\"  name=\"item_meta[126]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_127_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield frm_last_third  arf_inline_field_value  arf_field_127\"  style='width: 37.398%' data-field-type=\"text\" data-parent_field=\"124\" ><label data-type=\"text\" for=\"field_dfdqtk_73261\" class=\"arf_main_label arf_main_label_18px\">\u1793\u17b6\u1798\u178f\u17d2\u179a\u1780\u17bc\u179b<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_dfdqtk_73261\"  name=\"item_meta[127]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_128_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_128\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"124\"><label data-type=\"textarea\" for=\"field_6bo2un_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u17d0\u1799\u178a\u17d2\u178b\u17b6\u1793<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[128]\" id=\"field_6bo2un_73261\"  rows=\"3\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_129_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_129\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"124\"><label data-type=\"email\" for=\"field_ezv4dx_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u1799\u178a\u17d2\u178b\u17b6\u1793\u17a2\u17ca\u17b8\u1798\u17c2\u179b\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u17d4<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input type=\"text\" id=\"field_ezv4dx_73261\" name=\"item_meta[129]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\" data-validation-regex-message=\"Email is invalid\"  \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_130_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_phone  top_container  top_container arfformfield frm_first_half  arf_inline_field_value  arf_field_130\"  style='width: 48.07%'  data-field-type=\"phone\" data-parent_field=\"124\"><label data-type=\"phone\" for=\"field_o7qqkd_73261\" class=\"arf_main_label arf_main_label_18px\">\u179b\u17c1\u1781\u1791\u17bc\u179a\u179f\u17d0\u1796\u17d2\u1791 (\u1795\u17d2\u1791\u17c7)<\/label><div class=\"controls\"   ><input type=\"text\" data-type=\"phone\"  id=\"field_o7qqkd_73261\"name=\"item_meta[130]\"data-validation-number-message=\"Phone is invalid\"\/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_123_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_phone  top_container  top_container arfformfield frm_last_half  arf_inline_field_value  arf_field_123\"  style='width: 48.07%'  data-field-type=\"phone\" data-parent_field=\"124\"><label data-type=\"phone\" for=\"field_676kzl_73261\" class=\"arf_main_label arf_main_label_18px\">\u179b\u17c1\u1781\u1791\u17bc\u179a\u179f\u17d0\u1796\u17d2\u1791\u1785\u179b\u17d0\u178f (\u1791\u17bc\u179a\u179f\u17d0\u1796\u17d2\u1791)<\/label><div class=\"controls\"   ><input type=\"text\" data-type=\"phone\"  id=\"field_676kzl_73261\"name=\"item_meta[123]\"data-validation-number-message=\"Phone is invalid\"\/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_157_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_157\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"124\"><label data-type=\"textarea\" for=\"field_e62s42_73261\" class=\"arf_main_label arf_main_label_18px\">\u178f\u17be\u17a2\u17d2\u1793\u1780\u1794\u17b6\u1793\u17ae\u17a2\u17c6\u1796\u17b8\u1780\u17b6\u179a\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f\u179f\u1798\u17d2\u179a\u17b6\u1794\u17cb\u1780\u17d2\u179a\u17bb\u1798\u1787\u17c6\u1793\u17bd\u1799\u1787\u1793\u1797\u17c0\u179f\u1781\u17d2\u179b\u17bd\u1793 Hillingdon (\u201cHRSG\u201d) \u1793\u17c5\u17af\u178e\u17b6?<\/label><div class=\"controls\"   ><textarea name=\"item_meta[157]\" id=\"field_e62s42_73261\"  rows=\"3\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_155\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_155\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' ><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_156_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_156\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"155\"><label data-type=\"checkbox\" for=\"field_fxbwf_73261\" class=\"arf_main_label arf_main_label_18px\">\u1787\u17c6\u1793\u17b6\u1789 \u1793\u17b7\u1784\u1785\u17c6\u178e\u17b6\u1794\u17cb\u17a2\u17b6\u179a\u1798\u17d2\u1798\u178e\u17cd\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u17d4<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-0-73261\" value=\"Teaching English\"    class=\"arf_required\"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-0-73261\" >\u1780\u17b6\u179a\u1794\u1784\u17d2\u179a\u17c0\u1793\u1797\u17b6\u179f\u17b6\u17a2\u1784\u17cb\u1782\u17d2\u179b\u17c1\u179f<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-1\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-1-73261\" value=\"Teaching Maths\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-1-73261\" >\u1780\u17b6\u179a\u1794\u1784\u17d2\u179a\u17c0\u1793\u1782\u178e\u17b7\u178f\u179c\u17b7\u1791\u17d2\u1799\u17b6<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-2\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-2-73261\" value=\"Teaching Life skills, budgeting, etc.\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-2-73261\" >\u1794\u1784\u17d2\u179a\u17c0\u1793\u1787\u17c6\u1793\u17b6\u1789\u1787\u17b8\u179c\u17b7\u178f \u1780\u17b6\u179a\u179a\u17c0\u1794\u1785\u17c6\u1790\u179c\u17b7\u1780\u17b6\u17d4\u179b\u17d4<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-3\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-3-73261\" value=\"Admin \/Clerical\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-3-73261\" >\u17a2\u17d2\u1793\u1780\u1782\u17d2\u179a\u1794\u17cb\u1782\u17d2\u179a\u1784 \/ \u179f\u17d2\u1798\u17c0\u1793<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-4\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-4-73261\" value=\"Arts and Crafts\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-4-73261\" >\u179f\u17b7\u179b\u17d2\u1794\u17c8 \u1793\u17b7\u1784\u179f\u17b7\u1794\u17d2\u1794\u1780\u1798\u17d2\u1798<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-5\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-5-73261\" value=\"Car Owner\/ Driver\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-5-73261\" >\u1798\u17d2\u1785\u17b6\u179f\u17cb\u179a\u1790\u1799\u1793\u17d2\u178f\/\u17a2\u17d2\u1793\u1780\u1794\u17be\u1780\u1794\u179a<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-6\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-6-73261\" value=\"Computer Skills\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-6-73261\" >\u1787\u17c6\u1793\u17b6\u1789\u200b\u1780\u17bb\u17c6\u1796\u17d2\u1799\u17bc\u1791\u17d0\u179a<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-7\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-7-73261\" value=\"Form Filling, CV writing\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-7-73261\" >\u1780\u17b6\u179a\u1794\u17c6\u1796\u17c1\u1789\u1791\u1798\u17d2\u179a\u1784\u17cb\u1794\u17c2\u1794\u1794\u1791 \u1780\u17b6\u179a\u179f\u179a\u179f\u17c1\u179a CV<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-8\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-8-73261\" value=\"Youth Work\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-8-73261\" >\u1780\u17b6\u179a\u1784\u17b6\u179a\u1799\u17bb\u179c\u1787\u1793<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-9\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-9-73261\" value=\"Listening \/Befriending\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-9-73261\" >\u1780\u17b6\u179a\u179f\u17d2\u178f\u17b6\u1794\u17cb \/ \u1798\u17b7\u178f\u17d2\u178f\u1797\u17b6\u1796<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-10\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-10-73261\" value=\"Emotional Support\/ Counselling\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-10-73261\" >\u1780\u17b6\u179a\u1782\u17b6\u17c6\u1791\u17d2\u179a\u1795\u17d2\u1793\u17c2\u1780\u17a2\u17b6\u179a\u1798\u17d2\u1798\u178e\u17cd \/ \u1780\u17b6\u179a\u1794\u17d2\u179a\u17b9\u1780\u17d2\u179f\u17b6<\/label><\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_156-11\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[156][]\" data-type=\"checkbox\" id=\"field_156-11-73261\" value=\"Other \u2013 Please Specify below\"    class=\"arf_required\" style=''  onchange='arf_cl_apply_v3(73261,[\"\"]);arf_calculate_total(\"m3fbu4\",\"156\",[178,171,159,136,134]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_156-11-73261\" >\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f - \u179f\u17bc\u1798\u1794\u1789\u17d2\u1787\u17b6\u1780\u17cb\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1798<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_153_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_153\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"155\"><label data-type=\"textarea\" for=\"field_lfwd0q_73261\" class=\"arf_main_label arf_main_label_18px\">\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f<\/label><div class=\"controls\"   ><textarea name=\"item_meta[153]\" id=\"field_lfwd0q_73261\"  rows=\"3\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_154\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_154\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' >\u178a\u17be\u1798\u17d2\u1794\u17b8\u17a2\u17c4\u1799\u1799\u17be\u1784\u17a2\u17b6\u1785\u1794\u17d2\u179a\u17be\u1794\u17d2\u179a\u17b6\u179f\u17cb\u1787\u17c6\u1793\u17b6\u1789 \u1793\u17b7\u1784\u179f\u1798\u178f\u17d2\u1790\u1797\u17b6\u1796\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u1794\u17b6\u1793\u179b\u17d2\u17a2\u1794\u17c6\u1795\u17bb\u178f \u179f\u17bc\u1798\u1794\u17c6\u1796\u17c1\u1789\u1791\u1798\u17d2\u179a\u1784\u17cb\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1798\u17d4<\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_141\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_141\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' >\u179f\u17bc\u1798\u1795\u17d2\u178f\u179b\u17cb\u17a2\u17b6\u1787\u17d2\u1789\u17b6\u1780\u178e\u17d2\u178f\u17b6\u179b\u17af\u1780\u179a\u17b6\u1787\u17d2\u1799\u1796\u17b8\u179a\u1793\u17b6\u1780\u17cb\u178a\u17c2\u179b\u1798\u17b6\u1793\u1794\u17c6\u178e\u1784\u1795\u17d2\u178f\u179b\u17cb\u17af\u1780\u179f\u17b6\u179a\u1799\u17c4\u1784\u178f\u17bd\u17a2\u1780\u17d2\u179f\u179a (\u1791\u17b6\u17c6\u1784\u1793\u17c1\u17c7\u1798\u17b7\u1793\u178f\u17d2\u179a\u17bc\u179c\u1787\u17b6\u179f\u1798\u17b6\u1787\u17b7\u1780\u1782\u17d2\u179a\u17bd\u179f\u17b6\u179a\u1791\u17c1)<\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_136_73261_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_136\" data-field-type=\"html\" data-parent_field=\"141\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p>\u17a2\u17b6\u1787\u17d2\u1789\u17b6\u1780\u178e\u17d2\u178f\u17b6\u179b \u17e1<\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_137_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_137\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"141\" ><label data-type=\"text\" for=\"field_9de35o_73261\" class=\"arf_main_label arf_main_label_18px\">\u1788\u17d2\u1798\u17c4\u17c7<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_9de35o_73261\"  name=\"item_meta[137]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_138_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_138\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"141\"><label data-type=\"textarea\" for=\"field_5w0f1u_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u17d0\u1799\u178a\u17d2\u178b\u17b6\u1793<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[138]\" id=\"field_5w0f1u_73261\"  rows=\"3\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_139_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_139\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"141\"><label data-type=\"email\" for=\"field_4utwbm_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u17d0\u1799\u200b\u178a\u17d2\u178b\u17b6\u1793\u200b\u17a2\u17ca\u17b8\u200b\u1798\u17c9\u17c1\u200b\u179b<\/label><div class=\"controls\"   ><input type=\"text\" id=\"field_4utwbm_73261\" name=\"item_meta[139]\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\" data-validation-regex-message=\"Email is invalid\"  \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_140_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_phone  top_container  top_container arfformfield   arf_inline_field_value  arf_field_140\"  style='width: 100%'  data-field-type=\"phone\" data-parent_field=\"141\"><label data-type=\"phone\" for=\"field_k43a2j_73261\" class=\"arf_main_label arf_main_label_18px\">\u179b\u17c1\u1781\u1791\u17bc\u179a\u179f\u17d0\u1796\u17d2\u1791<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input type=\"text\" data-type=\"phone\"  id=\"field_k43a2j_73261\"name=\"item_meta[140]\" class=\"arf_required\"data-validation-required-message=\"This field cannot be blank.\"data-validation-number-message=\"Phone is invalid\"\/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_134_73261_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_134\" data-field-type=\"html\" data-parent_field=\"141\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p>\u17a2\u17b6\u1787\u17d2\u1789\u17b6\u1780\u178e\u17d2\u178f\u17b6\u179b \u17e2<\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_135_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_135\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"141\" ><label data-type=\"text\" for=\"field_j76w4a_73261\" class=\"arf_main_label arf_main_label_18px\">\u1788\u17d2\u1798\u17c4\u17c7<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_j76w4a_73261\"  name=\"item_meta[135]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_133_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_133\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"141\"><label data-type=\"textarea\" for=\"field_t53ysm_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u17d0\u1799\u178a\u17d2\u178b\u17b6\u1793<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[133]\" id=\"field_t53ysm_73261\"  rows=\"3\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_132_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_132\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"141\"><label data-type=\"email\" for=\"field_cun9oj_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u179f\u17d0\u1799\u200b\u178a\u17d2\u178b\u17b6\u1793\u200b\u17a2\u17ca\u17b8\u200b\u1798\u17c9\u17c1\u200b\u179b<\/label><div class=\"controls\"   ><input type=\"text\" id=\"field_cun9oj_73261\" name=\"item_meta[132]\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\" data-validation-regex-message=\"Email is invalid\"  \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_131_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_phone  top_container  top_container arfformfield   arf_inline_field_value  arf_field_131\"  style='width: 100%'  data-field-type=\"phone\" data-parent_field=\"141\"><label data-type=\"phone\" for=\"field_1kovvw_73261\" class=\"arf_main_label arf_main_label_18px\">\u179b\u17c1\u1781\u1791\u17bc\u179a\u179f\u17d0\u1796\u17d2\u1791<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input type=\"text\" data-type=\"phone\"  id=\"field_1kovvw_73261\"name=\"item_meta[131]\" class=\"arf_required\"data-validation-required-message=\"This field cannot be blank.\"data-validation-number-message=\"Phone is invalid\"\/><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><div style='clear:both;height:1px;'>&nbsp;<\/div><\/div><div class=\"arfsubmitbutton arf_submit_div top_container\" id=\"arf_submit_div_0\" ><input type=\"submit\" class=\"next_btn\" name=\"next\" value=\"\u1794\u1793\u17d2\u1791\u17b6\u1794\u17cb\" \/><\/div><div id=\"page_1\" class=\"page_break\" style=\"display:none;\"><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_158\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_158\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' ><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_159_73261_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_159\" data-field-type=\"html\" data-parent_field=\"158\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p class=\"center\"><b>\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb<\/b><\/p><br><br><p><b>\u1780\u17b6\u179a\u1787\u17d2\u179a\u17be\u179f\u179a\u17be\u179f\u17a2\u178f\u17b8\u178f\u1787\u1793\u179b\u17d2\u1798\u17be\u179f<\/b> \u2013 \u1797\u17b6\u1782\u1785\u17d2\u179a\u17be\u1793\u1793\u17c3\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f\u179a\u1794\u179f\u17cb\u1780\u17d2\u179a\u17bb\u1798\u1782\u17b6\u17c6\u1791\u17d2\u179a\u1787\u1793\u1797\u17c0\u179f\u1781\u17d2\u179b\u17bd\u1793 Hillingdon \u1793\u17b9\u1784\u1796\u17b6\u1780\u17cb\u1796\u17d0\u1793\u17d2\u1792\u1793\u17b9\u1784\u1780\u17b6\u179a\u1791\u17c6\u1793\u17b6\u1780\u17cb\u1791\u17c6\u1793\u1784\u178a\u17c4\u1799\u1795\u17d2\u1791\u17b6\u179b\u17cb\u1787\u17b6\u1798\u17bd\u1799\u1799\u17bb\u179c\u1787\u1793\u178a\u17c2\u179b\u1784\u17b6\u1799\u179a\u1784\u1782\u17d2\u179a\u17c4\u17c7\u17d4<br>\u178a\u17bc\u1785\u1793\u17c1\u17c7 \u1780\u17b6\u179a\u178a\u17b6\u1780\u17cb\u1796\u17b6\u1780\u17d2\u1799\u179f\u17bb\u17c6\u17a2\u17d2\u1793\u1780\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u179b\u17be\u1780\u179b\u17c2\u1784\u1796\u17b8\u1785\u17d2\u1794\u17b6\u1794\u17cb\u179f\u17d2\u178f\u17b6\u179a\u1793\u17b8\u178f\u17b7\u179f\u1798\u17d2\u1794\u1791\u17b6\u17a2\u17d2\u1793\u1780\u1794\u17d2\u179a\u1796\u17d2\u179a\u17b9\u178f\u17d2\u178f\u179b\u17d2\u1798\u17be\u179f\u1786\u17d2\u1793\u17b6\u17c6 1974 \u17d4<br>\u1793\u17c1\u17c7\u1798\u17b6\u1793\u1793\u17d0\u1799\u1790\u17b6 \u17a2\u17d2\u1793\u1780\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f\u178a\u17c2\u179b\u1798\u17b6\u1793\u179f\u1780\u17d2\u178a\u17b6\u1793\u17bb\u1796\u179b\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u178f\u1798\u17d2\u179a\u17bc\u179c\u17b1\u17d2\u1799\u1794\u17d2\u179a\u1780\u17b6\u179f\u17a2\u17c6\u1796\u17b8\u1780\u17c6\u178e\u178f\u17cb\u178f\u17d2\u179a\u17b6\u17a7\u1780\u17d2\u179a\u17b7\u178a\u17d2\u178b\u1780\u1798\u17d2\u1798\u1791\u17b6\u17c6\u1784\u1798\u17bc\u179b\u179a\u1794\u179f\u17cb\u1796\u17bd\u1780\u1782\u17c1 \u179a\u17bd\u1798\u1791\u17b6\u17c6\u1784\u1780\u17b6\u179a\u1794\u17d2\u179a\u17bb\u1784\u1794\u17d2\u179a\u1799\u17d0\u178f\u17d2\u1793 \u1780\u17b6\u179a\u179f\u17d2\u178f\u17b8\u1794\u1793\u17d2\u1791\u17c4\u179f \u1780\u17b6\u179a\u1796\u17d2\u179a\u1798\u17b6\u1793\u1785\u17bb\u1784\u1780\u17d2\u179a\u17c4\u1799 \u1793\u17b7\u1784\u1780\u17b6\u179a\u1795\u17d2\u178f\u1793\u17d2\u1791\u17b6\u1791\u17c4\u179f\u1796\u17d2\u179a\u17a0\u17d2\u1798\u1791\u178e\u17d2\u178c\u178a\u17c2\u179b\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1785\u17b6\u178f\u17cb\u1790\u17d2\u1793\u17b6\u1780\u17cb\u1787\u17b6 &#39;\u1785\u17c6\u178e\u17b6\u1799&#39; \u1793\u17c5\u1780\u17d2\u179a\u17c4\u1798\u1785\u17d2\u1794\u17b6\u1794\u17cb\u1781\u17b6\u1784\u179b\u17be\u17d4<br>\u179f\u17bc\u1798\u1794\u17c6\u1796\u17c1\u1789 \u17a0\u17be\u1799\u1785\u17bb\u17c7\u17a0\u178f\u17d2\u1790\u179b\u17c1\u1781\u17b6\u179b\u17be\u1795\u17d2\u1793\u17c2\u1780\u1793\u17c1\u17c7\u17d4<br>\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u178a\u17c2\u179b\u1794\u17b6\u1793\u1795\u17d2\u178f\u179b\u17cb\u1793\u17b9\u1784\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u179a\u1780\u17d2\u179f\u17b6\u1791\u17bb\u1780\u1787\u17b6\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb\u17d4<br>\u179c\u17b6\u1793\u17b9\u1784\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1794\u1784\u17d2\u17a0\u17b6\u1789\u178a\u179b\u17cb\u1794\u17bb\u1782\u17d2\u1782\u179b\u17b7\u1780 HRSG \u1787\u17b6\u1780\u17cb\u179b\u17b6\u1780\u17cb\u178f\u17c2\u1794\u17c9\u17bb\u178e\u17d2\u178e\u17c4\u17c7 \u1794\u17d2\u179a\u179f\u17b7\u1793\u1794\u17be\/\u1793\u17c5\u1796\u17c1\u179b\u178a\u17c2\u179b\u1796\u17bd\u1780\u1782\u17c1\u1780\u17c6\u1796\u17bb\u1784\u1796\u17b7\u1785\u17b6\u179a\u178e\u17b6\u17a2\u17d2\u1793\u1780\u179f\u1798\u17d2\u179a\u17b6\u1794\u17cb\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f\u1787\u17b6\u1780\u17cb\u179b\u17b6\u1780\u17cb (\u178a\u17c2\u179b\u1787\u17b6\u1780\u1793\u17d2\u179b\u17c2\u1784\u178a\u17c2\u179b\u17a2\u17d2\u1793\u1780\u17a2\u17b6\u1785\u1791\u17b6\u1780\u17cb\u1791\u1784\u1787\u17b6\u1798\u17bd\u1799\u1798\u1793\u17bb\u179f\u17d2\u179f\u179c\u17d0\u1799\u1780\u17d2\u1798\u17c1\u1784\u178a\u17c2\u179b\u1784\u17b6\u1799\u179a\u1784\u1782\u17d2\u179a\u17c4\u17c7)\u17d4<br><\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_160_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_160\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"158\"><label data-type=\"radio\" for=\"field_w3uqxw_73261\" class=\"arf_main_label arf_main_label_18px\">\u178f\u17be\u200b\u17a2\u17d2\u1793\u1780\u200b\u1792\u17d2\u179b\u17b6\u1794\u17cb\u200b\u178f\u17d2\u179a\u17bc\u179c\u200b\u1794\u17b6\u1793\u200b\u1780\u17b6\u178f\u17cb\u200b\u1791\u17c4\u179f\u200b\u1793\u17c5\u200b\u178f\u17bb\u179b\u17b6\u1780\u17b6\u179a \u17ac\u200b\u178f\u17d2\u179a\u17bc\u179c\u200b\u1794\u17c9\u17bc\u179b\u17b7\u179f\u200b\u1796\u17d2\u179a\u1798\u17b6\u1793\u200b\u1796\u17b8\u200b\u1794\u1791\u200b\u179b\u17d2\u1798\u17be\u179f\u200b\u178e\u17b6\u200b\u1798\u17bd\u1799\u200b\u178a\u17c2\u179a\u200b\u17ac\u200b\u1791\u17c1?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[160]\" data-type=\"radio\" id=\"field_160-0-73261\" data-unique-id=\"73261\" value=\"Yes\"   class=\"arf_required\" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_160-0-73261\" class=\"\">\u1794\u17b6\u1791<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[160]\" data-type=\"radio\" id=\"field_160-1-73261\" data-unique-id=\"73261\" value=\"No\"   class=\"arf_required\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_160-1-73261\" class=\"\">\u1791\u17c1<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_161_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_161\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"158\"><label data-type=\"textarea\" for=\"field_xoel3c_73261\" class=\"arf_main_label arf_main_label_18px\">\u1794\u17d2\u179a\u179f\u17b7\u1793\u1794\u17be\u1794\u17b6\u1791\/\u1785\u17b6\u179f \u179f\u17bc\u1798\u1795\u17d2\u178f\u179b\u17cb\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u179b\u1798\u17d2\u17a2\u17b7\u178f \u179a\u17bd\u1798\u1791\u17b6\u17c6\u1784\u1780\u17b6\u179b\u1794\u179a\u17b7\u1785\u17d2\u1786\u17c1\u1791 \u1793\u17b7\u1784\u179b\u1780\u17d2\u1781\u178e\u17c8\u1793\u17c3\u1794\u1791\u179b\u17d2\u1798\u17be\u179f\u17d4<\/label><div class=\"controls\"   ><textarea name=\"item_meta[161]\" id=\"field_xoel3c_73261\"  rows=\"3\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_162_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_162\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"158\"><label data-type=\"checkbox\" for=\"field_nsdv01_73261\" class=\"arf_main_label arf_main_label_18px\">\u1781\u17d2\u1789\u17bb\u17c6\u179f\u17bc\u1798\u1794\u17d2\u179a\u1780\u17b6\u179f\u1790\u17b6 \u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u1781\u17b6\u1784\u179b\u17be\u1782\u17ba\u178f\u17d2\u179a\u17b9\u1798\u178f\u17d2\u179a\u17bc\u179c\u17d4<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_162-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[162][]\" data-type=\"checkbox\" id=\"field_162-0-73261\" value=\"Yes\"    class=\"arf_required\"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  onchange='clearTimeout(__arf_timeout_handle); __arf_timeout_handle = setTimeout(function(){arf_calculate_total(\"m3fbu4\",\"162\",[178,171,159,136,134]);},100);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_162-0-73261\" ><\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_163_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield frm_first_half  arf_inline_field_value  arf_field_163\"  style='width: 48.07%' data-field-type=\"text\" data-parent_field=\"158\" ><label data-type=\"text\" for=\"field_6ml0hp_73261\" class=\"arf_main_label arf_main_label_18px\">\u1788\u17d2\u1798\u17c4\u17c7\u200b\u1796\u17c1\u1789<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_6ml0hp_73261\"  name=\"item_meta[163]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_164_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_date  top_container  top_container arfformfield frm_last_half arf_field_164\"  style='width: 48.07%'  data-field-type=\"date\" data-parent_field=\"158\"><label data-type=\"date\" for=\"field_zltbyd_73261\" class=\"arf_main_label arf_main_label_18px\">\u1780\u17b6\u179b\u1794\u179a\u17b7\u1785\u17d2\u1786\u17c1\u1791<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls arf_date_main_controls\"   ><input type=\"text\" data-date-format=\"MMM D, YYYY\" data-start-date=\"01\/01\/1950 00:00 AM\" data-cl-format=\"YYYY-MM-DD\" data-date-new-format=\"MM\/DD\/YYYY\" data-end-date=\"12\/31\/2050 11:59 PM\" data-default-date=\"\" id=\"field_zltbyd_73261\"    class=\"arf_required frm_date\" data-name='item_meta[164]' data-format='MMM D, YYYY' data-field-options=\"{&quot;required&quot;:&quot;1&quot;,&quot;required_indicator&quot;:&quot;*&quot;,&quot;blank&quot;:&quot;This field cannot be blank.&quot;,&quot;field_width&quot;:&quot;&quot;,&quot;locale&quot;:&quot;en&quot;,&quot;currentdefaultdate&quot;:&quot;&quot;,&quot;name&quot;:&quot;Date&quot;,&quot;default_value&quot;:&quot;&quot;,&quot;description&quot;:&quot;&quot;,&quot;placeholdertext&quot;:&quot;&quot;,&quot;show_time_calendar&quot;:&quot;&quot;,&quot;frm_show_time_calendar_field_indicator&quot;:&quot;&quot;,&quot;clock&quot;:&quot;12&quot;,&quot;step&quot;:&quot;30&quot;,&quot;off_days&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;arf_show_min_current_date&quot;:&quot;0&quot;,&quot;arf_show_max_current_date&quot;:&quot;0&quot;,&quot;arf_tooltip&quot;:&quot;&quot;,&quot;frm_arf_tooltip_field_indicator&quot;:&quot;&quot;,&quot;tooltip_text&quot;:&quot;&quot;,&quot;enable_arf_prefix&quot;:&quot;&quot;,&quot;arf_prefix_icon&quot;:&quot;&quot;,&quot;enable_arf_suffix&quot;:&quot;&quot;,&quot;arf_suffix_icon&quot;:&quot;&quot;,&quot;classes&quot;:&quot;arf_2&quot;,&quot;inner_class&quot;:&quot;arf_2col&quot;,&quot;key&quot;:&quot;zltbyd&quot;,&quot;selectdefaultdate&quot;:&quot;&quot;,&quot;arfnewdateformat&quot;:&quot;&quot;,&quot;css_outer_wrapper&quot;:&quot;&quot;,&quot;css_label&quot;:&quot;&quot;,&quot;css_input_element&quot;:&quot;&quot;,&quot;css_description&quot;:&quot;&quot;,&quot;css_add_icon&quot;:&quot;&quot;,&quot;type&quot;:&quot;date&quot;,&quot;arf_enable_readonly&quot;:&quot;0&quot;,&quot;has_parent&quot;:&quot;1&quot;,&quot;parent_field&quot;:&quot;158&quot;,&quot;parent_field_type&quot;:&quot;section&quot;,&quot;image_position_from&quot;:&quot;top_left&quot;,&quot;clear_on_focus&quot;:&quot;0&quot;,&quot;default_blank&quot;:&quot;0&quot;}\" data-validation-required-message=\"This field cannot be blank.\" \/><input type=\"hidden\" name=\"item_meta[164]\" id=\"field_zltbyd_73261_formatted\" \/><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_166\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_166\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' >\u1791\u1798\u17d2\u179a\u1784\u17cb\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799\u1787\u17d2\u179a\u17be\u179f\u179a\u17be\u179f\u1794\u17bb\u1782\u17d2\u1782\u179b\u17b7\u1780 (\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb)<\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_167_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_167\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"166\"><label data-type=\"checkbox\" for=\"field_y9vrl4_73261\" class=\"arf_main_label arf_main_label_18px\">\u179f\u1798\u17d2\u179a\u17b6\u1794\u17cb\u1782\u17c4\u179b\u1794\u17c6\u178e\u1784\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799 \u179f\u17bc\u1798\u1794\u17c6\u1796\u17c1\u1789\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17be\u1782\u17d2\u1793\u17b6\u178a\u17c2\u179b\u1797\u17d2\u1787\u17b6\u1794\u17cb\u1798\u1780\u1787\u17b6\u1798\u17bd\u1799\u17d4<br>\u17a2\u1793\u17bb\u179b\u17c4\u1798\u178f\u17b6\u1798\u1785\u17d2\u1794\u17b6\u1794\u17cb\u1780\u17b6\u179a\u1796\u17b6\u179a\u1791\u17b7\u1793\u17d2\u1793\u1793\u17d0\u1799\u1786\u17d2\u1793\u17b6\u17c6 1998 \u1781\u17d2\u1789\u17bb\u17c6\u1799\u179b\u17cb\u1796\u17d2\u179a\u1798\u1790\u17b6 HRSG \u17a2\u17b6\u1785\u179a\u1780\u17d2\u179f\u17b6\u1791\u17bb\u1780 \u1793\u17b7\u1784\u1794\u17d2\u179a\u17be\u1794\u17d2\u179a\u17b6\u179f\u17cb\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u1795\u17d2\u1791\u17b6\u179b\u17cb\u1781\u17d2\u179b\u17bd\u1793\u17a2\u17c6\u1796\u17b8\u1781\u17d2\u1789\u17bb\u17c6\u179f\u1798\u17d2\u179a\u17b6\u1794\u17cb\u17a0\u17c1\u178f\u17bb\u1795\u179b\u179f\u17d2\u1798\u17d0\u1782\u17d2\u179a\u1785\u17b7\u178f\u17d2\u178f \u1793\u17b7\u1784\u178a\u17be\u1798\u17d2\u1794\u17b8\u179a\u1780\u17d2\u179f\u17b6\u1791\u17c6\u1793\u17b6\u1780\u17cb\u1791\u17c6\u1793\u1784\u1787\u17b6\u1798\u17bd\u1799\u1781\u17d2\u1789\u17bb\u17c6\u17d4 \u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u1793\u17c1\u17c7 \u179a\u17bd\u1798\u1791\u17b6\u17c6\u1784\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u178a\u17c2\u179b\u1798\u17b6\u1793\u1793\u17c5\u1780\u17d2\u1793\u17bb\u1784\u1780\u1798\u17d2\u1798\u179c\u17b7\u1792\u17b8\u1793\u17c1\u17c7 \u17a2\u17b6\u1785\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u179a\u1780\u17d2\u179f\u17b6\u1791\u17bb\u1780\u1791\u17b6\u17c6\u1784\u17af\u1780\u179f\u17b6\u179a\u179f\u17c0\u179c\u1797\u17c5\u178a\u17c3 \u1793\u17b7\u1784\u1780\u17bb\u17c6\u1796\u17d2\u1799\u17bc\u1791\u17d0\u179a\u17d4<br>\u1781\u17d2\u1789\u17bb\u17c6\u179f\u17bc\u1798\u1794\u1789\u17d2\u1787\u17b6\u1780\u17cb\u1790\u17b6\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u1793\u17c5\u179b\u17be\u1791\u1798\u17d2\u179a\u1784\u17cb\u1793\u17c1\u17c7\u1782\u17ba\u178f\u17d2\u179a\u17b9\u1798\u178f\u17d2\u179a\u17bc\u179c\u17d4 \u1781\u17d2\u1789\u17bb\u17c6\u1799\u179b\u17cb\u1790\u17b6\u1780\u17b7\u1785\u17d2\u1785\u1780\u17b6\u179a\u1798\u17bd\u1799\u1785\u17c6\u1793\u17bd\u1793\u178a\u17c2\u179b\u1796\u17b6\u1780\u17cb\u1796\u17d0\u1793\u17d2\u1792\u1793\u17b9\u1784\u178f\u17bd\u1793\u17b6\u1791\u17b8\u179a\u1794\u179f\u17cb\u1781\u17d2\u1789\u17bb\u17c6\u1787\u17b6\u1798\u17bd\u1799 HRSG \u17a2\u17b6\u1785\u1798\u17b6\u1793\u179b\u1780\u17d2\u1781\u178e\u17c8\u179a\u179f\u17be\u1794 \u17a0\u17be\u1799\u1781\u17d2\u1789\u17bb\u17c6\u1799\u179b\u17cb\u1796\u17d2\u179a\u1798\u179a\u1780\u17d2\u179f\u17b6\u1780\u17b6\u179a\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb\u1782\u17d2\u179a\u1794\u17cb\u1796\u17c1\u179b\u179c\u17c1\u179b\u17b6\u17d4<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_167-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[167][]\" data-type=\"checkbox\" id=\"field_167-0-73261\" value=\"Yes\"    class=\"arf_required\"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  onchange='clearTimeout(__arf_timeout_handle); __arf_timeout_handle = setTimeout(function(){arf_calculate_total(\"m3fbu4\",\"167\",[178,171,159,136,134]);},100);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_167-0-73261\" ><\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_168_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield frm_first_half  arf_inline_field_value  arf_field_168\"  style='width: 48.07%' data-field-type=\"text\" data-parent_field=\"166\" ><label data-type=\"text\" for=\"field_47wnp3_73261\" class=\"arf_main_label arf_main_label_18px\">\u1788\u17d2\u1798\u17c4\u17c7\u200b\u1796\u17c1\u1789<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_47wnp3_73261\"  name=\"item_meta[168]\"  class=\"arf_required\" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_169_73261_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_date  top_container  top_container arfformfield frm_last_half arf_field_169\"  style='width: 48.07%'  data-field-type=\"date\" data-parent_field=\"166\"><label data-type=\"date\" for=\"field_ik603a_73261\" class=\"arf_main_label arf_main_label_18px\">\u1780\u17b6\u179b\u1794\u179a\u17b7\u1785\u17d2\u1786\u17c1\u1791<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls arf_date_main_controls\"   ><input type=\"text\" data-date-format=\"MMM D, YYYY\" data-start-date=\"01\/01\/1950 00:00 AM\" data-cl-format=\"YYYY-MM-DD\" data-date-new-format=\"MM\/DD\/YYYY\" data-end-date=\"12\/31\/2050 11:59 PM\" data-default-date=\"\" id=\"field_ik603a_73261\"    class=\"arf_required frm_date\" data-name='item_meta[169]' data-format='MMM D, YYYY' data-field-options=\"{&quot;required&quot;:&quot;1&quot;,&quot;required_indicator&quot;:&quot;*&quot;,&quot;blank&quot;:&quot;This field cannot be blank.&quot;,&quot;field_width&quot;:&quot;&quot;,&quot;locale&quot;:&quot;en&quot;,&quot;currentdefaultdate&quot;:&quot;&quot;,&quot;name&quot;:&quot;Date&quot;,&quot;default_value&quot;:&quot;&quot;,&quot;description&quot;:&quot;&quot;,&quot;placeholdertext&quot;:&quot;&quot;,&quot;show_time_calendar&quot;:&quot;&quot;,&quot;frm_show_time_calendar_field_indicator&quot;:&quot;&quot;,&quot;clock&quot;:&quot;12&quot;,&quot;step&quot;:&quot;30&quot;,&quot;off_days&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;arf_show_min_current_date&quot;:&quot;0&quot;,&quot;arf_show_max_current_date&quot;:&quot;0&quot;,&quot;arf_tooltip&quot;:&quot;&quot;,&quot;frm_arf_tooltip_field_indicator&quot;:&quot;&quot;,&quot;tooltip_text&quot;:&quot;&quot;,&quot;enable_arf_prefix&quot;:&quot;&quot;,&quot;arf_prefix_icon&quot;:&quot;&quot;,&quot;enable_arf_suffix&quot;:&quot;&quot;,&quot;arf_suffix_icon&quot;:&quot;&quot;,&quot;classes&quot;:&quot;arf_2&quot;,&quot;inner_class&quot;:&quot;arf_2col&quot;,&quot;key&quot;:&quot;ik603a&quot;,&quot;selectdefaultdate&quot;:&quot;&quot;,&quot;arfnewdateformat&quot;:&quot;&quot;,&quot;css_outer_wrapper&quot;:&quot;&quot;,&quot;css_label&quot;:&quot;&quot;,&quot;css_input_element&quot;:&quot;&quot;,&quot;css_description&quot;:&quot;&quot;,&quot;css_add_icon&quot;:&quot;&quot;,&quot;type&quot;:&quot;date&quot;,&quot;arf_enable_readonly&quot;:&quot;0&quot;,&quot;has_parent&quot;:&quot;1&quot;,&quot;parent_field&quot;:&quot;166&quot;,&quot;parent_field_type&quot;:&quot;section&quot;,&quot;image_position_from&quot;:&quot;top_left&quot;,&quot;clear_on_focus&quot;:&quot;0&quot;,&quot;default_blank&quot;:&quot;0&quot;}\" data-validation-required-message=\"This field cannot be blank.\" \/><input type=\"hidden\" name=\"item_meta[169]\" id=\"field_ik603a_73261_formatted\" \/><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_170\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_170\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' ><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_171_73261_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_171\" data-field-type=\"html\" data-parent_field=\"170\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p class=\"center\">HRSG \u179b\u17be\u1780\u1780\u1798\u17d2\u1796\u179f\u17cb\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17be\u1782\u17d2\u1793\u17b6<\/p><br>\n<p><b>\u1782\u17c4\u179b\u1793\u1799\u17c4\u1794\u17b6\u1799\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17be\u1782\u17d2\u1793\u17b6\u1780\u17d2\u1793\u17bb\u1784\u1780\u17b6\u179a\u1787\u17d2\u179a\u17be\u179f\u179a\u17be\u179f \u1793\u17b7\u1784\u1787\u17d2\u179a\u17be\u179f\u179a\u17be\u179f<\/b><\/p>\n\u1791\u1798\u17d2\u179a\u1784\u17cb\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799\u1787\u17d2\u179a\u17be\u179f\u179a\u17be\u179f\u1794\u17bb\u1782\u17d2\u1782\u179b\u17b7\u1780 (\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb) \u1780\u17d2\u179a\u17bb\u1798\u1782\u17b6\u17c6\u1791\u17d2\u179a\u1787\u1793\u1797\u17c0\u179f\u1781\u17d2\u179b\u17bd\u1793 Hillingdon \u1794\u17d2\u178f\u17c1\u1787\u17d2\u1789\u17b6\u1785\u17c6\u1796\u17c4\u17c7\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17be\u1782\u17d2\u1793\u17b6\u1780\u17d2\u1793\u17bb\u1784\u1780\u17b6\u179a\u1784\u17b6\u179a\u17d4<br>\u178a\u17be\u1798\u17d2\u1794\u17b8\u1792\u17b6\u1793\u17b6\u1794\u17b6\u1793\u1793\u17bc\u179c\u1794\u17d2\u179a\u179f\u17b7\u1791\u17d2\u1792\u1797\u17b6\u1796\u1793\u17c3\u1782\u17c4\u179b\u1780\u17b6\u179a\u178e\u17cd\u1793\u17c1\u17c7 \u1794\u17c1\u1780\u17d2\u1781\u1787\u1793\u1791\u17b6\u17c6\u1784\u17a2\u179f\u17cb\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u179f\u17d2\u1793\u17be\u179f\u17bb\u17c6\u17b1\u17d2\u1799\u1795\u17d2\u178f\u179b\u17cb\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u178a\u17bc\u1785\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1798\u17d4<br>\u179a\u17b6\u179b\u17cb\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u178a\u17c2\u179b\u1794\u17b6\u1793\u1795\u17d2\u178f\u179b\u17cb\u17b1\u17d2\u1799\u1793\u17b9\u1784\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1785\u17b6\u178f\u17cb\u1791\u17bb\u1780\u178a\u17c4\u1799\u1797\u17b6\u1796\u1787\u17bf\u1787\u17b6\u1780\u17cb\u178a\u17cf\u178f\u17b9\u1784\u179a\u17c9\u17b9\u1784\u1794\u17c6\u1795\u17bb\u178f \u17a0\u17be\u1799\u1793\u17b9\u1784\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1794\u17d2\u179a\u17be\u179f\u1798\u17d2\u179a\u17b6\u1794\u17cb\u178f\u17c2\u1782\u17c4\u179b\u1794\u17c6\u178e\u1784\u1793\u17c3\u1780\u17b6\u179a\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799\u1794\u17c9\u17bb\u178e\u17d2\u178e\u17c4\u17c7\u17d4<br><p><b>\u1780\u17b6\u179a\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799<\/b><\/p>\n\u1799\u17be\u1784\u1793\u17b9\u1784\u1785\u17b6\u178f\u17cb\u1791\u17bb\u1780\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1798\u1787\u17b6\u1780\u17b6\u179a\u179f\u1798\u17d2\u1784\u17b6\u178f\u17cb \u17a0\u17be\u1799\u1799\u17be\u1784\u179f\u17bc\u1798\u1790\u17d2\u179b\u17c2\u1784\u17a2\u17c6\u178e\u179a\u1782\u17bb\u178e\u1785\u17c6\u1796\u17c4\u17c7\u1780\u17b7\u1785\u17d2\u1785\u179f\u17a0\u1794\u17d2\u179a\u178f\u17b7\u1794\u178f\u17d2\u178f\u17b7\u1780\u17b6\u179a\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u1780\u17d2\u1793\u17bb\u1784\u1780\u17b6\u179a\u1787\u17bd\u1799\u1799\u17be\u1784\u1780\u17d2\u1793\u17bb\u1784\u1780\u17b6\u179a\u178f\u17d2\u179a\u17bd\u178f\u1796\u17b7\u1793\u17b7\u178f\u17d2\u1799\u1794\u17d2\u179a\u179f\u17b7\u1791\u17d2\u1792\u1797\u17b6\u1796\u1793\u17c3\u1782\u17c4\u179b\u1793\u1799\u17c4\u1794\u17b6\u1799\u17b1\u1780\u17b6\u179f\u179f\u17d2\u1798\u17be\u1782\u17d2\u1793\u17b6\u179a\u1794\u179f\u17cb\u1799\u17be\u1784\u17d4<br>\u1796\u17b6\u1780\u17d2\u1799\u179f\u17d2\u1793\u17be\u179f\u17bb\u17c6\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u1793\u17b9\u1784\u1798\u17b7\u1793\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1794\u17c9\u17c7\u1796\u17b6\u179b\u17cb\u178a\u17c4\u1799\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u178a\u17c2\u179b\u1794\u17b6\u1793\u1795\u17d2\u178f\u179b\u17cb\u17b1\u17d2\u1799\u1791\u17c1 \u17a0\u17be\u1799\u1793\u17b9\u1784\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1794\u17c6\u1794\u17c2\u1780\u1785\u17c1\u1789\u1796\u17b8\u1791\u1798\u17d2\u179a\u1784\u17cb\u1796\u17b6\u1780\u17d2\u1799\u179f\u17bb\u17c6\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u1793\u17c5\u179b\u17be\u1794\u1784\u17d2\u1780\u17b6\u1793\u17cb\u178a\u17c3\u17d4<\/p><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_172\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_172\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top' style='display:block'; data-field-type='section' ><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_173_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_173\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_9z9vjc_73261\" class=\"arf_main_label arf_main_label_18px\">\u1797\u17c1\u1791<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[173]\" data-type=\"radio\" id=\"field_173-0-73261\" data-unique-id=\"73261\" value=\"Male\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_173-0-73261\" class=\"\">\u1794\u17d2\u179a\u17bb\u179f<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[173]\" data-type=\"radio\" id=\"field_173-1-73261\" data-unique-id=\"73261\" value=\"Female\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_173-1-73261\" class=\"\">\u179f\u17d2\u179a\u17b8<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_174_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_174\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_f59t2k_73261\" class=\"arf_main_label arf_main_label_18px\">\u17a2\u17b6\u1799\u17bb<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-0-73261\" data-unique-id=\"73261\" value=\"16-20\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-0-73261\" class=\"\">16-20<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-1-73261\" data-unique-id=\"73261\" value=\"21-30\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-1-73261\" class=\"\">21-30<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-2-73261\" data-unique-id=\"73261\" value=\"31-40\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-2-73261\" class=\"\">31-40<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-3-73261\" data-unique-id=\"73261\" value=\"41-50\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-3-73261\" class=\"\">41-50<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-4-73261\" data-unique-id=\"73261\" value=\"51-60\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-4-73261\" class=\"\">51-60<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-5-73261\" data-unique-id=\"73261\" value=\"61-70\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-5-73261\" class=\"\">61-70<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-6-73261\" data-unique-id=\"73261\" value=\"71-80\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-6-73261\" class=\"\">71-80<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[174]\" data-type=\"radio\" id=\"field_174-7-73261\" data-unique-id=\"73261\" value=\"81-90\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_174-7-73261\" class=\"\">81-90<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_175_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_175\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_8z09pc_73261\" class=\"arf_main_label arf_main_label_18px\">\u178a\u17be\u1798\u1780\u17c6\u178e\u17be\u178f\u1787\u1793\u1787\u17b6\u178f\u17b7 \u1781\u17d2\u1789\u17bb\u17c6\u1793\u17b9\u1784\u1796\u178e\u17cc\u1793\u17b6\u17a2\u17c6\u1796\u17b8\u178a\u17be\u1798\u1780\u17c6\u178e\u17be\u178f\u1787\u1793\u1787\u17b6\u178f\u17b7\u179a\u1794\u179f\u17cb\u1781\u17d2\u1789\u17bb\u17c6\u178a\u17bc\u1785\u1787\u17b6\u17d6<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-0-73261\" data-unique-id=\"73261\" value=\"White (English)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-0-73261\" class=\"\">\u179f (\u17a2\u1784\u17cb\u1782\u17d2\u179b\u17c1\u179f)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-1-73261\" data-unique-id=\"73261\" value=\"White (Irish)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-1-73261\" class=\"\">\u179f (\u17a2\u17c0\u179a\u17a1\u1784\u17cb)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-2-73261\" data-unique-id=\"73261\" value=\"White (Gypsy) or Irish Traveller\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-2-73261\" class=\"\">\u1787\u1793\u1787\u17b6\u178f\u17b7\u179f\u17d2\u1794\u17c2\u1780\u179f (\u17a0\u17d2\u1782\u17b8\u1794\u179f\u17b8\u179f) \u17ac\u17a2\u17d2\u1793\u1780\u1792\u17d2\u179c\u17be\u178a\u17c6\u178e\u17be\u179a\u17a2\u17c0\u179a\u17a1\u1784\u17cb<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-3-73261\" data-unique-id=\"73261\" value=\"White (Scottish)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-3-73261\" class=\"\">\u179f (\u179f\u17d2\u1780\u17bb\u178f\u17a1\u17c1\u1793)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-4-73261\" data-unique-id=\"73261\" value=\"White (Welsh)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-4-73261\" class=\"\">\u179f (\u179c\u17c2\u179b)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-5-73261\" data-unique-id=\"73261\" value=\"Any other White background\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-5-73261\" class=\"\">\u1795\u17d2\u1791\u17c3\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1799\u1796\u178e\u17cc\u179f\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f\u17d4<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-6-73261\" data-unique-id=\"73261\" value=\"Asian (Indian)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-6-73261\" class=\"\">\u17a2\u17b6\u179f\u17ca\u17b8 (\u17a5\u178e\u17d2\u178c\u17b6)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-7-73261\" data-unique-id=\"73261\" value=\"Asian (Pakistani)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-7-73261\" class=\"\">\u17a2\u17b6\u179f\u17ca\u17b8 (\u1794\u17c9\u17b6\u1782\u17b8\u179f\u17d2\u1790\u17b6\u1793)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-8-73261\" data-unique-id=\"73261\" value=\"Asian (Bangladeshi)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-8-73261\" class=\"\">\u17a2\u17b6\u179f\u17ca\u17b8 (\u1794\u1784\u17cb\u1780\u17d2\u179b\u17b6\u178a\u17c2\u179f)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-9-73261\" data-unique-id=\"73261\" value=\"Asian (Chinese)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-9-73261\" class=\"\">\u17a2\u17b6\u179f\u17ca\u17b8 (\u1785\u17b7\u1793)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-10-73261\" data-unique-id=\"73261\" value=\"Any other Asian background\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-10-73261\" class=\"\">\u1794\u17d2\u179a\u179c\u178f\u17d2\u178f\u17b7\u17a2\u17b6\u179f\u17ca\u17b8\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f\u17d4<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-11-73261\" data-unique-id=\"73261\" value=\"Black (African)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-11-73261\" class=\"\">\u1781\u17d2\u1798\u17c5 (\u17a2\u17b6\u17a0\u17d2\u179a\u17d2\u179c\u17b7\u1780)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-12-73261\" data-unique-id=\"73261\" value=\"Black (Caribbean)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-12-73261\" class=\"\">\u1781\u17d2\u1798\u17c5 (\u1780\u17b6\u179a\u17b6\u1794\u17c0\u1793)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-13-73261\" data-unique-id=\"73261\" value=\"Any other Black, African, Caribbean background\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-13-73261\" class=\"\">\u1795\u17d2\u1791\u17c3\u1781\u17b6\u1784\u1780\u17d2\u179a\u17c4\u1799\u1781\u17d2\u1798\u17c5 \u17a2\u17b6\u17a0\u17d2\u179a\u17d2\u179c\u17b7\u1780 \u1780\u17b6\u179a\u17b6\u1794\u17c0\u1793<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-14-73261\" data-unique-id=\"73261\" value=\"Mixed (White and Black Caribbean)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-14-73261\" class=\"\">\u1785\u1798\u17d2\u179a\u17bb\u17c7 (\u179f \u1793\u17b7\u1784\u1781\u17d2\u1798\u17c5 \u1780\u17b6\u179a\u17c9\u17b6\u1794\u17ca\u17b8\u1793)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-15-73261\" data-unique-id=\"73261\" value=\"Mixed (White and Black African)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-15-73261\" class=\"\">\u1785\u1798\u17d2\u179a\u17bb\u17c7 (\u17a2\u17b6\u17a0\u17d2\u179a\u17d2\u179c\u17b7\u1780\u179f \u1793\u17b7\u1784\u1781\u17d2\u1798\u17c5)<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-16-73261\" data-unique-id=\"73261\" value=\"Mixed (White and Asian)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-16-73261\" class=\"\">\u1785\u1798\u17d2\u179a\u17bb\u17c7 (\u179f \u1793\u17b7\u1784\u17a2\u17b6\u179f\u17ca\u17b8)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-17-73261\" data-unique-id=\"73261\" value=\"Other mixed ethnic background\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-17-73261\" class=\"\">\u179f\u17b6\u179c\u178f\u17b6\u1787\u17b6\u178f\u17b7\u179f\u17b6\u179f\u1793\u17cd\u1785\u1798\u17d2\u179a\u17bb\u17c7\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f\u17d4<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-18-73261\" data-unique-id=\"73261\" value=\"Other ethnic background (Arab)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-18-73261\" class=\"\">\u179f\u17b6\u179c\u178f\u17b6\u1787\u1793\u1787\u17b6\u178f\u17b7\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f (\u17a2\u17b6\u179a\u17c9\u17b6\u1794\u17cb)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[175]\" data-type=\"radio\" id=\"field_175-19-73261\" data-unique-id=\"73261\" value=\"Any other ethnic background\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_175-19-73261\" class=\"\">\u179f\u17b6\u179c\u178f\u17b6\u1787\u1793\u1787\u17b6\u178f\u17b7\u1795\u17d2\u179f\u17c1\u1784\u17d7<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_176_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_176\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_mcq04e_73261\" class=\"arf_main_label arf_main_label_18px\">\u179f\u17b6\u179f\u1793\u17b6 \u17ac\u1787\u17c6\u1793\u17bf\u17d6<br>\u179f\u17bc\u1798\u1794\u1789\u17d2\u1787\u17b6\u1780\u17cb\u17a2\u17c6\u1796\u17b8\u179f\u17b6\u179f\u1793\u17b6 \u17ac\u1787\u17c6\u1793\u17bf\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u17d4<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-0-73261\" data-unique-id=\"73261\" value=\"No religion (Atheism)\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-0-73261\" class=\"\">\u1782\u17d2\u1798\u17b6\u1793\u179f\u17b6\u179f\u1793\u17b6 (Atheism)<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-1-73261\" data-unique-id=\"73261\" value=\"Christianity\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-1-73261\" class=\"\">\u1782\u17d2\u179a\u17b7\u179f\u17d2\u178f\u179f\u17b6\u179f\u1793\u17b6<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-2-73261\" data-unique-id=\"73261\" value=\"Buddhism\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-2-73261\" class=\"\">\u1796\u17bb\u1791\u17d2\u1792\u179f\u17b6\u179f\u1793\u17b6<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-3-73261\" data-unique-id=\"73261\" value=\"Hinduism\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-3-73261\" class=\"\">\u1796\u17d2\u179a\u17a0\u17d2\u1798\u1789\u17d2\u1789\u179f\u17b6\u179f\u1793\u17b6<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-4-73261\" data-unique-id=\"73261\" value=\"Islam\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-4-73261\" class=\"\">\u17a5\u179f\u17d2\u179b\u17b6\u1798<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-5-73261\" data-unique-id=\"73261\" value=\"Judaism\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-5-73261\" class=\"\">\u179f\u17b6\u179f\u1793\u17b6\u1799\u17bc\u178a\u17b6<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-6-73261\" data-unique-id=\"73261\" value=\"Sikhism\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-6-73261\" class=\"\">\u179f\u17b6\u179f\u1793\u17b6\u179f\u17ca\u17b8\u1780<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-7-73261\" data-unique-id=\"73261\" value=\"Other\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-7-73261\" class=\"\">\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[176]\" data-type=\"radio\" id=\"field_176-8-73261\" data-unique-id=\"73261\" value=\"I do not wish to disclose my religion\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_176-8-73261\" class=\"\">\u1781\u17d2\u1789\u17bb\u17c6\u200b\u1798\u17b7\u1793\u200b\u1785\u1784\u17cb\u200b\u1794\u1784\u17d2\u17a0\u17b6\u1789\u200b\u179f\u17b6\u179f\u1793\u17b6\u200b\u179a\u1794\u179f\u17cb\u200b\u1781\u17d2\u1789\u17bb\u17c6\u200b\u1791\u17c1\u17d4<\/label><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_177_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_177\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_zulg38_73261\" class=\"arf_main_label arf_main_label_18px\">\u178f\u17be\u17a2\u17d2\u1793\u1780\u1785\u17b6\u178f\u17cb\u1791\u17bb\u1780\u1781\u17d2\u179b\u17bd\u1793\u17af\u1784\u1790\u17b6\u1796\u17b7\u1780\u17b6\u179a\u178a\u17c2\u179a\u17ac\u1791\u17c1?<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[177]\" data-type=\"radio\" id=\"field_177-0-73261\" data-unique-id=\"73261\" value=\"Yes\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_177-0-73261\" class=\"\">\u1794\u17b6\u1791<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[177]\" data-type=\"radio\" id=\"field_177-1-73261\" data-unique-id=\"73261\" value=\"No\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_177-1-73261\" class=\"\">\u1791\u17c1<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[177]\" data-type=\"radio\" id=\"field_177-2-73261\" data-unique-id=\"73261\" value=\"I do not wish to disclose this information                \"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_177-2-73261\" class=\"\">\u1781\u17d2\u1789\u17bb\u17c6\u200b\u1798\u17b7\u1793\u200b\u1785\u1784\u17cb\u200b\u1794\u1784\u17d2\u17a0\u17b6\u1789\u200b\u1796\u17d0\u178f\u17cc\u1798\u17b6\u1793\u200b\u1793\u17c1\u17c7\u200b\u1791\u17c1\u17d4                <\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_178_73261_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_178\" data-field-type=\"html\" data-parent_field=\"172\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p>\u1793\u17c5\u1796\u17c1\u179b\u1786\u17d2\u179b\u17be\u1799\u179f\u17c6\u178e\u17bd\u179a\u1793\u17c1\u17c7 \u179f\u17bc\u1798\u1785\u17c6\u178e\u17b6\u17c6\u1790\u17b6\u1793\u17c5\u1780\u17d2\u179a\u17c4\u1798\u1785\u17d2\u1794\u17b6\u1794\u17cb\u179f\u17d2\u178f\u17b8\u1796\u17b8\u1780\u17b6\u179a\u179a\u17be\u179f\u17a2\u17be\u1784\u1796\u17b7\u1780\u17b6\u179a\u1797\u17b6\u1796\u1786\u17d2\u1793\u17b6\u17c6 1995 \u1796\u17b7\u1780\u17b6\u179a\u1797\u17b6\u1796\u1798\u17bd\u1799\u178f\u17d2\u179a\u17bc\u179c\u1794\u17b6\u1793\u1780\u17c6\u178e\u178f\u17cb\u1790\u17b6\u1787\u17b6 &quot;\u1796\u17b7\u1780\u17b6\u179a\u1797\u17b6\u1796\u1795\u17d2\u179b\u17bc\u179c\u1785\u17b7\u178f\u17d2\u178f \u17ac\u179a\u17b6\u1784\u1780\u17b6\u1799&quot; \u178a\u17c2\u179b\u1798\u17b6\u1793\u1795\u179b\u1794\u17c9\u17c7\u1796\u17b6\u179b\u17cb\u1799\u17c9\u17b6\u1784\u1792\u17d2\u1784\u1793\u17cb\u1792\u17d2\u1784\u179a \u1793\u17b7\u1784\u179a\u1799\u17c8\u1796\u17c1\u179b\u179c\u17c2\u1784\u1791\u17c5\u179b\u17be\u179f\u1798\u178f\u17d2\u1790\u1797\u17b6\u1796\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u1780\u17d2\u1793\u17bb\u1784\u1780\u17b6\u179a\u17a2\u1793\u17bb\u179c\u178f\u17d2\u178f\u179f\u1780\u1798\u17d2\u1798\u1797\u17b6\u1796\u1794\u17d2\u179a\u1785\u17b6\u17c6\u1790\u17d2\u1784\u17c3\u1792\u1798\u17d2\u1798\u178f\u17b6\u17d4<\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_179_73261_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_179\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"172\"><label data-type=\"radio\" for=\"field_girqb7_73261\" class=\"arf_main_label arf_main_label_18px\">\u179f\u17bc\u1798\u1785\u1784\u17d2\u17a2\u17bb\u179b\u1794\u1784\u17d2\u17a0\u17b6\u1789\u1790\u17b6\u1796\u17b6\u1780\u17d2\u1799\u178e\u17b6\u178a\u17c2\u179b\u1796\u17b7\u1796\u178e\u17cc\u1793\u17b6\u17a2\u17c6\u1796\u17b8\u1796\u17b7\u1780\u17b6\u179a\u1797\u17b6\u1796\u179a\u1794\u179f\u17cb\u17a2\u17d2\u1793\u1780\u17d6<\/label><div class=\"setting_radio controls arf_standard_radio\" style=\"padding-top:5px;\"><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-0-73261\" data-unique-id=\"73261\" value=\"Dyslexia\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-0-73261\" class=\"\">\u1787\u17c6\u1784\u17ba\u1781\u17d2\u179c\u17c7\u1788\u17b6\u1798<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-1-73261\" data-unique-id=\"73261\" value=\"Sight impediment\/blind\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-1-73261\" class=\"\">\u1796\u17b7\u1780\u17b6\u179a\u1797\u17d2\u1793\u17c2\u1780 \/ \u1796\u17b7\u1780\u17b6\u179a\u1797\u17d2\u1793\u17c2\u1780<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-2-73261\" data-unique-id=\"73261\" value=\"Hearing impediment\/deaf\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-2-73261\" class=\"\">\u1780\u17b6\u179a\u179a\u17c6\u1781\u17b6\u1793\u178a\u179b\u17cb\u1780\u17b6\u179a\u179f\u17d2\u178f\u17b6\u1794\u17cb \/ \u1790\u17d2\u179b\u1784\u17cb<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-3-73261\" data-unique-id=\"73261\" value=\"Wheelchair user\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-3-73261\" class=\"\">\u17a2\u17d2\u1793\u1780\u1794\u17d2\u179a\u17be\u1794\u17d2\u179a\u17b6\u179f\u17cb\u179a\u1791\u17c1\u17c7\u179a\u17bb\u1789<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-4-73261\" data-unique-id=\"73261\" value=\"Other mobility issues\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-4-73261\" class=\"\">\u1794\u1789\u17d2\u17a0\u17b6\u1785\u179b\u17d0\u178f\u1795\u17d2\u179f\u17c1\u1784\u1791\u17c0\u178f\u17d4<\/label><\/div><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-5-73261\" data-unique-id=\"73261\" value=\"Mental Health Condition\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-5-73261\" class=\"\">\u179f\u17d2\u1790\u17b6\u1793\u1797\u17b6\u1796\u179f\u17bb\u1781\u1797\u17b6\u1796\u1795\u17d2\u179b\u17bc\u179c\u1785\u17b7\u178f\u17d2\u178f<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton\"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[179]\" data-type=\"radio\" id=\"field_179-6-73261\" data-unique-id=\"73261\" value=\"Disability \"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_179-6-73261\" class=\"\">\u1796\u17b7\u1780\u17b6\u179a\u1797\u17b6\u1796 <\/label><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><div style=\"clear:both;height:1px;\">&nbsp;<\/div><\/div><!-- page_break && page_0--><div class=\"arfsubmitbutton top_container\" id=\"page_last\" 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btn-info arfstyle-button  unknown\"  id=\"arf_submit_btn_73261\" name=\"arf_submit_btn_73261\" data-style=\"zoom-in\"  ><span class=\"arfsubmitloader\"><\/span><span class=\"arfstyle-label\">\u17a2\u1793\u17bb\u179c\u178f\u17d2\u178f<\/span><\/button><\/div><\/div><div style=\"clear:both\"><\/div><\/div><!-- arf_fieldset --><\/div><!-- allfields --><input type=\"hidden\" name=\"trp-form-language\" value=\"km\"\/><\/form><script type='text\/javascript' data-cfasync='false'>if(!window['arf_conditional_logic']){window['arf_conditional_logic'] = new Array();}window['arf_conditional_logic'][73261] = {\"logic\":[],\"dependents\":[],\"defaults\":[]};if(!window['arf_pages_fields']){window['arf_pages_fields'] = new Array();}window['arf_pages_fields'][73261] = 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